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Today, the links in the American Heart Association version of the Chain of Survival are: Immediate recognition of cardiac arrest and activation of the emergency response system. Early CPR with an emphasis on chest compressions. Rapid defibrillation. Effective advanced life support. Integrated post-cardiac arrest care.
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Read More »The Chain of Survival from Sudden Cardiac Arrest Sudden cardiac arrest (SCA) is a sudden and unexpected pulseless condition caused by a disturbance in the heart’s electrical activity. The electrical disturbance may be due to a heart attack, a severe imbalance of electrolytes, an inherited genetic mutation that predisposes the heart to electric abnormalities, an electric shock (e.g., from lightning), or blunt force trauma to the chest leading to commotio cordis. Symptoms include an almost instantaneous loss of consciousness and collapse. The treatment goal for SCA is to restore a healthy heart rhythm and good neurological outcome. (Graham R, 2015) SCA strikes approximately 326,200 (Mozaffarian D, 2015) to 395,000 (Graham R, 2015) individuals outside hospitals each year in the U.S., including an estimated 6,328 people less than 18 years of age (Mozaffarian D, 2015). On average, about one in 10 victims survives (Graham R: 6%; Mozaffarian D: 10.6%), though some high performing communities have achieved survival rates of more than 60% for specific types of cardiac arrest (Graham R, 2015). The majority of people who survive SCA invariably receive immediate help from bystanders at the scene. The time between the onset of arrest and the provision of care determines the likelihood of survival. If treatment is not provided within 10 minutes, the survival rate is close to zero. Because minutes count, the public plays a crucial role in saving lives threatened by SCA. (Graham R, 2015) The “Chain of Survival” refers to the chain of events that must occur in rapid succession to maximize the chances of survival from SCA. When the Chain of Survival metaphor was first created and described, it included early recognition, early access, early CPR, early defibrillation and early advanced life support (Newman M, 1989, 1990). The metaphor was a simple way to educate the public about its vital role in helping SCA victims, suggesting that each link is critical and interdependent, and the Chain of Survival is only as strong as its weakest link. The concept was later adopted by the American Heart Association (Cummins R, 1991) and other health organizations. Subsequently, the Chain of Survival was revisited to emphasize the importance of early recognition and response (Newman M, Bahr R, 1998). As post-resuscitation care options expanded to include mild therapeutic hypothermia and other treatments, another link, integrated post-cardiac arrest care, was added to the Chain (Hazinski M, 2010). Today, the links in the American Heart Association version of the Chain of Survival are: Immediate recognition of cardiac arrest and activation of the emergency response system Early CPR with an emphasis on chest compressions Rapid defibrillation Effective advanced life support Integrated post-cardiac arrest care. Bystanders can help save lives by addressing the first three links in the Chain of Survival. Action steps for bystanders are described below.
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Read More »If a shock is needed, the device will instruct the rescuer to press the shock button. In fully automatic devices, the shock will be delivered automatically. AEDs are designed for use by untrained laypersons. They are safe, effective, and intuitive devices that will not shock a victim unless a shock is needed to restore a normal heartbeat. They cannot harm the victim. AEDs are safe for use with children. If the child is age 1-8 and a pediatric dose-attenuator is available, the rescuer should use it. If this adapter is not available, the rescuer should use a standard AED.
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